• Title/Summary/Keyword: 외상환자

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Treatment of Traumatic Vascular Injury (외상성 혈관 손상의 치료)

  • 장인석;최준영;김종우;이정은;이상호
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.590-594
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    • 2003
  • Vascular injury has been increased with popular outside activities. However there are only a few studies for vascular trauma. We intended to find out the relationships between the vascular trauma and its prognosis. Material and Method: Forty-four patients were diagnosed and operated on for vascular injury in the Gyeongsang National University Hospital from 1992. to 1999. We reviewed their chart and analysed their data retrospectively. We studied to causes, treatments, and prognoses of traumatic vascular injury. Result: The transfer time between accident place and emergency department was mean 3,5 hour, and the operation preparing time was 8.8 hours. Five cases required amputation of extremity. All amputation cases were combined with communited bony fractures. Thirty-eight cases had combined other injuries, and almost combined injuries were muscular and neurological damages, Conclusion: The optimal treatment plan for vascular trauma was prompt diagnosis and quick management. It may decrease amputation rate and post-traumatic complications. Therefore we must be carefully evaluated the multiple traumatic patients for early diagnosis of vascular injury and operate quickly in emergency status.

Factors Influencing Post-Traumatic Growth in Traffic Accident Patient (교통사고 환자의 외상후 성장 영향요인)

  • Cha, Hye Ji;Bang, Sul Yeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.254-264
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    • 2019
  • This study is a descriptive correlation study investigating the effects of stress disorder symptoms, resilience, and social network on post-traumatic growth in traffic accident patients. The participants were 158 traffic accident cases enrolled from five 100-bed hospitals situated in city C. Data were collected from July 1 to August 31, 2018, and analyzed by t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using SPSS / Win23. The explanatory power of post-traumatic growth was determined to be 36.9%, and the factors affecting post-traumatic growth were social network and post-traumatic stress disorder. In addition, social networks completely established the relationship between resilience and post-traumatic growth. Our results confirmed that a wider social network and increased symptoms of post-traumatic stress disorder of the traffic accident patient are associated with higher post-traumatic growth. Therefore, it is necessary to explore approaches that improve the social networks and resilience to help post-traumatic growth of traffic accident patients. Additional research is required through repetitive and long-term observation of the accident victims.

Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.53-62
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    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

The Usefullness of Percutaneous Transarterial Embolization in Patients with Severe Multiple Traumas (다발성 손상에 의한 중증외상환자의 경피적 동맥색전술의 유용성)

  • You, In-Gyu;Lim, Cheong-Hwan
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.107-114
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    • 2012
  • The study was conducted in patients who had undergone angiography and arterial embolization after being diagnosed with arterial bleeding among those registered with severe trauma at the admission to the department of emergency due to accidents. In the study, comparison was done between the survived group and the nonsurvived group to investigate the usefulness and the optimal performance timing of angiography and embolization as the survival-affecting factors and treatment methods for patients. The study was performed as a retrospective analysis in 45 patients who had undergone angiography and arterial embolization among those categorized as severe trauma patients from the emergency department of H hospital located in Gyeonggi-do from July, 2006 until December, 2010. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the hematocrit were the main outcome measurements. Arterial embolization was technically successful in all cases, transcatheter arterial embolization of arterial bleeding is a useful procedure in lowering the mortality and complication in severe trauma patients. and RTS, ISS, Hematocrit were the predictable early mortality factors. So bad vital sign patients must be progressed rapidly.

Surgical Management of Traumatic Cardiac Injury (외상에 의한 심장 손상의 수술적 치료)

  • 강준규;윤유상;김형태;박인덕;소동문;이철주
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.335-341
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    • 2004
  • Traumatic cardiac injury is very rare but mortality is very high when the diagnosis and management are delayed. We reviewed our case retrospectively. Material and Method: From March 1995 to July 2003, 17 patients were diagnosed as having traumatic cardiac rupture. Five patients were stabbed, seven patients were motor vehicle accidents, four patients had fallen down, and the cause was unknown in one patient. Emergency operations were done and six patients were operated under CPB. Result: Four patients died during or after operation. The mean ICU stay period was 3.86$\pm$3.35 days and the mean hospital stay was 18.27$\pm$14.99 days. No mortality was observed in those whose vital signs were stable in the operating room. Conclusion: Preoperative vital status was very important and thoracic traumatic patient should be suspected as having cardiac injury.

Posttraumatic Stress Disorder of Patients Referred to Psychiatry after Motor Vehicle Accidents (자동차사고 후 정신과로 의뢰된 환자의 외상후 스트레스장애)

  • Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.174-183
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    • 1999
  • Objective : This study was designed to evaluate the incidence and characteristics of posttraumatic stress disorder(PTSD) after motor vehicle accidents(MVA) in 44 consecutive MVA victims referred to psychiatry for the diagnosis, treatment and psychiatric assessment. Method : The diagnosis of posttraumatic stress disorder was made on the basis of DSM-IV criteria, and posttraumatic stress symptoms were assessed by the Clinician-Administered PTSD Scale(CAPS). Correlation between the extent of physical injury and the severity of PTSD symptoms using the Abbreviated Injury Scale(AIS) was analyzed and the frequency of psychiatric comorbidity of PTSD was invested. Result : Twenty-two(45.5%) MVA victims met DSM-IV criteria for PTSD, while thirteen(29.5%) showed a subsyndromal form of it. AIS scores significantly related with the development of posttraumatic stress symptoms(r=0.565, p=0.0001). PTSD group showed high percentages of each of the 17 symptoms(criterion B, C, D), while subsyndromal PTSD group showed relatively high percentages of criterion Band D. The most frequent symptom was 'distressing dreams' of criterion B in both group. A high percentages(56%) of the MVA-PTSD group also met the criteria for current major depression. Conclusions : These findings suggest that there is apparently a high likelihood of developing all or part of the PTSD syndrome after motor vehicle accidents. So it does appear that for those MVA victims who seek medical attention and eventually need psychiatric referral, diagnostic possibility of PTSD should be taken into account in treatment planning and early intervention.

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Reliability and Validatity of a Korean version of Posttraumatic Growth Inventory Among Cancer Caregivers (암환자 가족을 대상으로 한 '외상 후 성장 척도(K-PTGI)'의 타당도 검증)

  • Rhee, Young-Sun
    • Korean Journal of Social Welfare Studies
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    • v.40 no.2
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    • pp.123-143
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    • 2009
  • To investigate the reliability, validity of posttraumatic growth among Korean cancer caregiver, 295 participants were asked to complete a Korean posttraumatic growth inventory, translated from the Posttraumatic Growth Inventory (PTGI; J Trauma Stress 1996; 9: 455.471), together with the Caregiver burden scale, life style interruption scale, economic burden scale and positive adaptation scale, social support scale and questions about religious and demographic factors. Cronbach's alpha was 0.95 for the K-PTGI, indicating sufficient internal consistencies. Construct and Criterion validity were also supported. K-PTGI appeared to be a sound measure for the experience of posttraumatic growth in cancer caregivers and this study result will be able to contribute to facilitate future research.

CONTINUED ROOT DEVELOPMENT AFTER AVULSION OF IMMATURE TEETH (미성숙 영구치의 탈구성 외상 이후 계속된 치근 성장)

  • Lee, Ju-Eun;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.2
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    • pp.127-132
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    • 2013
  • Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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